BETH ANGLE (NPI# 1639683824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639683824 |
| Entity Type | Individual |
| Full Name | BETH ANGLE |
| Practice Address |
904 E. Martin Luther King Drive Centralia IL 62801-3058 |
| Practice Telephone | 6185331391 |
| Practice Fax Number | 6185330012 |
| Mailing Telephone | 6185331391 |
| Mailing Fax Number | 6185330012 |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2017-11-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 043123661 | IL | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 370915481007 | 05 |
| Street Address |
904 E. MARTIN LUTHER KING DRIVE |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-3058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780762815 | Melissa Aberg West | Psychiatry & Neurology | 904 E. Martin Luther King Drive, Centralia, IL 62801 | 2006-11-02 |
| 1316509615 | Alayna Moore | Counselor | 904 E. Martin Luther King Drive, Centralia, IL 62801-3058 | 2019-07-08 |
| 1598239998 | Dawn Martinez-uribe | Counselor | 904 E. Martin Luther King Drive, Centralia, IL 62801-3058 | 2019-01-18 |
| 1720560808 | Paula Armstrong | Counselor | 904 E. Martin Luther King Drive, Centralia, IL 62801 | 2018-09-05 |
| 1417437211 | Kurtiss Hassebrock | Counselor | 904 E. Martin Luther King Drive, Centralia, IL 62801-3058 | 2018-08-21 |
| 1144700980 | Linda Hanna | Counselor | 904 E. Martin Luther King Drive, Centralia, IL 62801-3058 | 2018-08-21 |
| 1457831299 | Nadia Riazati | Counselor | 904 E. Martin Luther King Drive, Centralia, IL 62801-3058 | 2018-08-21 |
| 1316431331 | Adam Borges | Counselor | 904 E. Martin Luther King Drive, Centralia, IL 62801-3058 | 2018-06-22 |
| 1720571342 | Brittany Brown | Counselor | 904 E. Martin Luther King Drive, Centralia, IL 62801-3058 | 2018-06-08 |
| 1326540121 | Wendy Suey | Counselor | 904 E. Martin Luther King Drive, Centralia, IL 62801-3058 | 2018-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205469103 | Vicki Lee Lucht | Licensed Practical Nurse | 3510 Steelhammer Dr # 3, Centralia, WA 98531-4551 | 2020-02-19 |
| 1316561764 | Molly Kathleen Bryan | Licensed Practical Nurse | 3510 Steelhammer Dr, Centralia, WA 98531-4551 | 2020-06-02 |
| 1598398265 | Czareenah Dela Cruz Apostol | Licensed Practical Nurse | 904 E Martin Luther King Dr, Centralia, IL 62801-3058 | 2020-02-20 |
| 1467019653 | Patty Kathleen Noble | Licensed Practical Nurse | 3510 Steelhammer Dr, Centralia, WA 98531-4551 | 2019-05-22 |
| 1346804002 | Charlet Mersereau | Licensed Practical Nurse | 3510 Steelhammer Dr, Centralia, WA 98531-4551 | 2019-04-29 |
| 1215591060 | Steven Gomez | Licensed Practical Nurse | 3510 Steelhammer Dr, Centralia, WA 98531-4551 | 2019-04-26 |
| 1023287406 | Darice Teitzel | Licensed Practical Nurse | 1900 Cooks Hill Rd, Centralia, WA 98531-9073 | 2008-02-29 |
| 1518135540 | Shawn Suessman | Licensed Practical Nurse | 1900 Cooks Hill Rd, Centralia, WA 98531-9073 | 2008-02-12 |
| 1922286475 | Washington Orthopaedic Center, Inc., Ps | Licensed Practical Nurse | 1900 Cooks Hill Rd, Centralia, WA 98531-9073 | 2008-02-07 |
| 1194903815 | Debra Axt | Licensed Practical Nurse | 1900 Cooks Hill Rd, Centralia, WA 98531-9073 | 2008-02-05 |
| Find all providers in CENTRALIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.